Doctors are raising alarm bells as Gaza residents turn to toxic tobacco alternative

Gaza residents have been suffering from massive supply shortages of necessities, ranging from essential goods like food products, medicine and baby nutrition to more leisurely pleasures like cigarettes. As tobacco all but disappears from Gaza, many smokers have turned to an unlikely substitute: dried molokhia leaves, a staple ingredient traditionally used in a thick stew. However, doctors say the improvised cigarettes are sending a growing number of people to hospitals with serious respiratory problems.

Several physicians working in respiratory and cardiac departments across Gaza have reported an increase in patients suffering from breathing difficulties, suffocation and facial discoloration, as Al Jazeera highlights.

Many believe this is linked to smoking molokhia cigarettes, and while Gaza's Ministry of Health has not officially confirmed the trend, frontline doctors say the cases are becoming increasingly common.

Dr. Ahmed Saeed al-Jadba, a consultant ear, nose and throat specialist, warned that burning molokhia could pose even greater health risks than conventional tobacco.

He said dried molokhia is often mixed with liquid nicotine — a known carcinogen — and, in some cases, industrial substances such as pest-control chemicals or battery oils, making the homemade cigarettes particularly hazardous.

“When these materials are burned, they release toxic gases like carbon monoxide and tar,” he says.

“These are the same harmful compounds found in traditional tobacco and are major causes of cancer and cellular damage over time.”

According to al-Jadba, patients have been arriving at clinics with severe coughing, persistent hoarseness and dark or yellow phlegm. Some have also been diagnosed with pre-cancerous lesions on their vocal cords.

One Gaza resident described suffering a serious accident after liquid nicotine leaked from a syringe he was carrying.

“I used to carry the nicotine syringe in my pocket,” he says. “It broke suddenly and leaked into my skin. It caused severe burns and penetrated the tissue. I would have died without God’s mercy.”

He said he had heard of several similar incidents at local markets, where mishandling liquid nicotine had reportedly caused severe injuries and, in some cases, deaths.

Despite understanding the dangers, he said addiction and financial hardship have made quitting extremely difficult.

The use of molokhia mixed with nicotine has become increasingly widespread as street vendors struggle to adapt to the wartime economy. What was once a modest business has become increasingly precarious amid restrictions on goods entering Gaza.

Israel has prohibited the entry of tobacco products into Gaza since the start of the war against Hamas, alongside broader restrictions affecting food and humanitarian supplies. Although many of those restrictions were expected to ease under the ceasefire that began in October, Israel has continued to limit what enters the territory, citing security concerns.

By Nazrin Sadigova